A Portable Trachea Spray for Lower Airway Humidification in Patients After Tracheostomy

Author(s):  
Tilman Keck ◽  
Ajnacska Rozsasi
Head & Neck ◽  
2008 ◽  
Vol 30 (5) ◽  
pp. 582-588 ◽  
Author(s):  
Tilman Keck ◽  
Ajnacska Rozsasi ◽  
Richard Leiacker ◽  
Marc Oliver Scheithauer

2001 ◽  
Vol 117 (6) ◽  
pp. 573-582 ◽  
Author(s):  
Yuanlin Song ◽  
Sujatha Jayaraman ◽  
Baoxue Yang ◽  
Michael A. Matthay ◽  
A.S. Verkman

Several aquaporin-type water channels are expressed in mammalian airways and lung: AQP1 in microvascular endothelia, AQP3 in upper airway epithelia, AQP4 in upper and lower airway epithelia, and AQP5 in alveolar epithelia. Novel quantitative methods were developed to compare airway fluid transport–related functions in wild-type mice and knockout mice deficient in these aquaporins. Lower airway humidification, measured from the moisture content of expired air during mechanical ventilation with dry air through a tracheotomy, was 54–56% efficient in wild-type mice, and reduced by only 3–4% in AQP1/AQP5 or AQP3/AQP4 double knockout mice. Upper airway humidification, measured from the moisture gained by dry air passed through the upper airways in mice breathing through a tracheotomy, decreased from 91 to 50% with increasing ventilation from 20 to 220 ml/min, and reduced by 3–5% in AQP3/AQP4 knockout mice. The depth and salt concentration of the airway surface liquid in trachea was measured in vivo using fluorescent probes and confocal and ratio imaging microscopy. Airway surface liquid depth was 45 ± 5 μm and [Na+] was 115 ± 4 mM in wild-type mice, and not significantly different in AQP3/AQP4 knockout mice. Osmotic water permeability in upper airways, measured by an in vivo instillation/sample method, was reduced by ∼40% by AQP3/AQP4 deletion. In doing these measurements, we discovered a novel amiloride-sensitive isosmolar fluid absorption process in upper airways (13% in 5 min) that was not affected by aquaporin deletion. These results establish the fluid transporting properties of mouse airways, and indicate that aquaporins play at most a minor role in airway humidification, ASL hydration, and isosmolar fluid absorption.


Critical Care ◽  
2014 ◽  
Vol 18 (Suppl 1) ◽  
pp. P341 ◽  
Author(s):  
F Van Someren Gréve ◽  
KF Van der Sluijs ◽  
NP Juffermans ◽  
T Winters ◽  
SP Rebers ◽  
...  

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Catherine L. Oberg ◽  
Reza Ronaghi ◽  
Erik E. Folch ◽  
Colleen L. Channick ◽  
Tao He ◽  
...  

<b><i>Background:</i></b> The coronavirus disease 2019 (COVID-19) pandemic has drastically affected hospital and operating room (OR) workflow around the world as well as trainee education. Many institutions have instituted mandatory preoperative SARS-CoV-2 PCR nasopharyngeal swab (NS) testing in patients who are low risk for COVID-19 prior to elective cases. This method, however, is challenging as the sensitivity, specificity, and overall reliability of testing remains unclear. <b><i>Objectives:</i></b> The objective of this study was to assess the concordance of a negative NS in low risk preoperative patients with lower airway bronchoalveolar lavage (BAL) specimens obtained from the same patients. <b><i>Methods:</i></b> We prospectively sent intraoperative lower airway BAL samples collected within 48 h of a negative mandatory preoperative NS for SARS-CoV-2 PCR testing. All adult patients undergoing a scheduled bronchoscopic procedure for any reason were enrolled, including elective and nonelective cases. <b><i>Results:</i></b> One-hundred eighty-nine patients were included. All BAL specimens were negative for SARS-CoV-2 indicative of 100% concordance between testing modalities. <b><i>Conclusions:</i></b> These results are promising and suggest that preoperative nasopharyngeal SARS-CoV-2 testing provides adequate screening to rule out active COVID-19 infection prior to OR cases in a population characterized as low risk by negative symptom screening. This information can be used for both pre-procedural screening and when reintroducing trainees into the workforce.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
F. Schleich ◽  
S. Graff ◽  
F. Guissard ◽  
M. Henket ◽  
V. Paulus ◽  
...  

Abstract Background Elderly asthmatics represent an important group that is often excluded from clinical studies. In this study we wanted to present characteristics of asthmatics older than 70 years old as compared to younger patients. Methods We conducted a retrospective analysis on a series of 758 asthmatics subdivided in three groups: lower than 40, between 40 and 70 and older than 70. All the patients who had a successful sputum induction were included in the study. Results Older patients had a higher Body Mass Index, had less active smokers and were more often treated with Long Acting anti-Muscarinic Agents. We found a significant increase in sputum neutrophil counts with ageing. There was no significant difference in blood inflammatory cell counts whatever the age group. Forced expiratory volume in one second (FEV1) and FEV1/FVC values were significantly lower in elderly who had lower bronchial hyperresponsiveness and signs of air trapping. We found a lower occurrence of the allergic component in advanced ages. Asthmatics older than 70 years old had later onset of the disease and a significant longer disease duration. Conclusion Our study highlights that asthmatics older than 70 years old have higher bronchial neutrophilic inflammation, a poorer lung function, signs of air trapping and lower airway variability. The role of immunosenescence inducing chronic low-grade inflammation in this asthma subtype remains to be elucidated.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Chieko Mitaka ◽  
Masataka Fukuda ◽  
Tsukasa Kochiyama ◽  
...  

Abstract Background Giant anterior mediastinal tumor (GAMT) resection is a challenging procedure, for which anesthesiologist might take to need special precautions. Case presentation A 48-year-old male patient had been scheduled to undergo GAMT resection and superior vena cava (SVC) replacement. The tumor spread surrounding SVC and left main bronchus (LMB), resulting in small volume of his left lung. A soft left-sided double lumen tube (DLT) was selected to keep the patency of LMB during left one lung ventilation (OLV) against the tumor weight. Semi-awake intubation with spontaneous breathing was selected for DLT insertion to avoid lower airway occlusion. During left OLV after right open thoracotomy, his SPO2 decreased below to 90%. We performed selective right upper lobe bronchial blockade using the combination of DLT and bronchial blocker. The surgery was successfully completed with this strategy. Conclusions Although such cases are rare, they are informative for anesthesiologists, providing optional strategies.


Heliyon ◽  
2021 ◽  
pp. e07283
Author(s):  
Kotaro Iwasaki ◽  
Yasuo Matsuzawa ◽  
Hiroki Wakabayashi ◽  
Moe Shioya ◽  
Sho Hayakawa ◽  
...  

2020 ◽  
Vol 7 ◽  
Author(s):  
Gabrielle Brankston ◽  
Amy L. Greer ◽  
Quinn Marshall ◽  
Brittany Lang ◽  
Kai Moore ◽  
...  
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